AREDS and AREDS2: Recommendations

The Age Related Eye Disease Study (AREDS) was designed to determine if dietary supplementation influenced the rate of both cataract formation and the development of macular degeneration (ARMD). The results of the initial study are well known, but difficult to remember. In essence, those with moderate to severe (or high risk) risk factors for macular degeneration developed choroidal neovascularization or severe atrophic changes 25% less than the cohort.

1. Beta-carotene, included in the original AREDS formulation, increased the rate of lung cancer in smokers. The AREDS formulation is not recommended for smokers.

2. Lutein/zeaxanthin were found to be associated inversely with development of neovascular AMD, atrophic AMD and the presence of large and intermediate drusen.

3. Omega 3 fatty acids were also found to be associated with a reduction in neovascular AMD.

AREDS2 is currently underway. It will be concluded in about 5 years. It is designed to answer the following questions; 1) the role of macular xanthophylls (e.g. lutein and zeaxanthin), 2) the role of omega-3 fatty acids in macular degeneration and its possible influence on dementia and cardiovascular diease, 3) the importance of beta-carotene.

Current Recommendations are that patients with moderate to large drusen in both eyes or advanced AMD (either CNV or geographic atrophy) in one eye take the AREDS formulation. Beta-carotene is contraindicated in smokers.